Bid No. ZNB 5768/2013-H

Transcription

1 DEPARTMENT OF HEALTH Bid No. THE SUPPLY OF HOSPITAL LINEN FOR VARIOUS INSTITUTIONS SCM Unit of KZN Department of Health BIDDER S NAME:. PROVINCIAL DATABASE NUMBER:... This document contains the entire pack of documents for The Supply of Hospital Linen for Various Institutions. The completed documents are to be submitted no later than the closing date and time specified. Page 1

2 TABLE OF CONTENTS PAGE COVER PAGE...1 TABLE OF CONTENTS...2 LOCALITY MAP STANDARD BID DOCUMENTATION SECTION A: INVITATION TO BID SECTION B: TAX CLEARANCE CERTIFICATE REQUIREMENTS... 6 SECTION C: SPECIAL INSTRUCTIONS AND NOTICES TO BIDDERS REGARDING THE COMPLETION OF BIDDING FORMS... 7 SECTION D: DECLARATION OF INTEREST SECTION F: PREFERENCE POINTS CLAIM FORM SECTION G: SECTION I: SECTION L: DECLARATION CERTIFICATE FOR LOCAL PRODUCTION AND CONTENT PRICING SCHEDULE (FIRM PRICES) DECLARATION THAT INFORMATION ON THE PROVINCIAL SUPPLIER DATABASE IS CORRECT AND UP TO DATE SECTION M: CERTIFICATE OF INDEPENDENT BID DETERMINATION SECTION O: AUTHORITY TO SIGN A BID SECTION P: SECTION S: DECLARATION OF BIDDERS PAST SUPPLY CHAIN MANAGEMENT PRACTICES SCHEDULE OF VARIATIONS FROM GOODS OR SERVICES INFORMATION SECTION T: SCHEDULE OF ALTERNATIVE BIDS SECTION U: SPECIAL TERMS AND CONDITIONS GENERAL CONDITIONS OF CONTRACT EVALUATION CRITERIA SPECIFICATION Page 2

3 INKOSI ALBERT LUTHULI ST LOCALITY MAP BID BOX NATALIA LONGMARKET ST CHURCH ST WE ARE HERE! CENTRAL SUPPLY CHAIN MANAGEMENT, CAPITAL TOWERS 121 CHIEF ALBERT LUTHULI STREET CHAPEL ST WEST ST PINE ST PIETERMARITZ ST SCHOOL THE INSTIT UTION MAYORS WALK Page 3

4 STANDARD BID DOCUMENTATION SECTION A INVITATION TO BID YOU ARE HEREBY INVITED TO BID FOR REQUIREMENTS OF THE DEPARTMNT OF HEALTH BID NUMBER: CLOSING DATE: CLOSING TIME: 11:00 DESCRIPTION: THE SUPPLY OF HOSPITAL LINEN FOR VARIOUS INSTITUTIONS CONTRACT PERIOD: 3 MONTHS VALIDITY PERIOD: 180 DAYS PROVINCIAL SUPPLIER DATABASE REGISTRATION NO:... The successful bidder will be required to fill in and sign a written Contract Form (SBD 13). BID DOCUMENTS TO BE: HEAD: DEPARTMENT OF HEALTH CENTRAL SUPPLY CHAIN MANAGEMENT DIRECTORATE PRIVATE BAG X9051 PIETERMARITZBURG, 3200 OR DEPOSITED IN THE BID BOX SITUATED AT CENTRAL SUPPLY CHAIN MANAGEMENT DIRECTORATE 121 CHIEF ALBERT LUTHULI ROAD PIETERMARITZBURG 3201 Bidders should ensure that bids are delivered timeously to the correct address. If the bid is late, it will not be accepted for consideration. The bid box is available on the following days and times: Monday to Friday 08H00-15H00. ALL BIDS MUST BE SUBMITTED ON THE OFFICIAL FORMS (NOT TO BE RE-TYPED) THIS BID IS SUBJECT TO THE PREFERENTIAL PROCUREMENT POLICY FRAMEWORK ACT AND THE PREFERENTIAL PROCUREMENT REGULATIONS, 2011, THE GENERAL CONDITIONS OF CONTRACT (GCC) AND, IF APPLICABLE, ANY OTHER SPECIAL CONDITIONS OF CONTRACT. Page 4

5 THE FOLLOWING PARTICULARS MUST BE FURNISHED (FAILURE TO DO SO MAY RESULT IN YOUR BID BEING DISQUALIFIED) NAME OF BIDDER POSTAL ADDRESS STREET ADDRESS TELEPHONE NUMBER CELLPHONE NUMBER FACSIMILE NUMBER ADDRESS. CODE NUMBER.. CODE.NUMBER. VAT REGISTRATION NUMBER HAS AN ORIGINAL AND VALID TAX CLEARANCE CERTIFICATE BEEN SUBMITTED TO PROVINCIAL TREASURY? (SBD 2) or NO YES HAS A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE BEEN SUBMITTED TO PROVINCIAL TREASURY? (SBD 6.1) YES or NO IF YES, WHO WAS THE CERTIFICATE ISSUED BY? AN ACCOUNTING OFFICER AS CONTEMPLATED IN THE CLOSE CORPORATION ACT (CCA).. A VERIFICATION AGENCY ACCREDITED BY THE SOUTH AFRICAN ACCREDITATION SYSTEM (SANAS); OR A REGISTERED AUDITOR..... [TICK APPLICABLE BOX] (A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE MUST BE SUBMITTED IN ORDER TO QUALIFY FOR PREFERENCE POINTS FOR B-BBEE) ARE YOU THE ACCREDITED REPRESENTATIVE IN SOUTH AFRICA FOR THE GOODS/SERVICES/WORKS OFFERED? NO [IF YES ENCLOSE PROOF] YES or SIGNATURE OF BIDDER DATE CAPACITY UNDER WHICH THIS BID IS SIGNED TOTAL BID PRICE ANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BE DIRECTED TO: Department: CENTRAL SUPPLY CHAIN MANAGEMENT DIRECTORATE Contact Person: Mr S Gasa Tel: Fax: address: simo.gasa@kznhealth.gov.za HOURS OF DUTY: 08:00-15:00 (MONDAY TO FRIDAY) ANY ENQUIRIES REGARDING TECHNICAL INFORMATION MAY BE DIRECTED TO: Contact Person: Mr E Ndlovu Tel: enock.ndlovu@kznhealth.gov.za Page 5

6 SECTION B TAX CLEARANCE CERTIFICATE REQUIREMENTS It is a condition of bid that the taxes of the successful bidder must be in order, or that satisfactory arrangements have been made with South African Revenue Service (SARS) to meet the bidder s tax obligations. 1 In order to meet this requirement bidders are required to complete in full the attached form TCC 001 Application for a Tax Clearance Certificate and submit it to any SARS branch office nationally. The Tax Clearance Certificate Requirements are also applicable to foreign bidders/individuals who wish to submit bids. 2 SARS will then furnish the bidder with a Tax Clearance Certificate that will be valid for a period of 1 (one) year from the date of approval. 3 The original Tax Clearance Certificate must be submitted together with the bid. Failure to submit the original and valid Tax Clearance Certificate will result in the invalidation of the bid. Certified copies of the Tax Clearance Certificate will not be acceptable. 4 In bids where Consortia/Joint Ventures/Sub-contractors are involved, each party must submit a separate Tax Clearance Certificate. 5 Copies of the TCC 001 Application for a Tax Clearance Certificate form are available from any SARS branch office nationally or on the website 6 Applications for the Tax Clearance Certificates may also be made via efiling. In order to use this provision, taxpayers will need to register with SARS as efilers through the website Page 6

7 SECTION C SPECIAL INSTRUCTIONS AND NOTICES TO BIDDERS REGARDING THE COMPLETION OF BIDDING FORMS PLEASE NOTE THAT THIS BID IS SUBJECT TO TREASURY REGULATIONS 16A ISSUED IN TERMS OF THE PUBLIC FINANCE MANAGEMENT ACT, 1999, THE KWAZULU-NATAL SUPPLY CHAIN MANAGEMENT POLICY FRAMEWORK AND THE GENERAL CONDITIONS OF CONTRACT. 1. Unless inconsistent with or expressly indicated otherwise by the context, the singular shall include the plural and visa versa and with words importing the masculine gender shall include the feminine and the neuter. 2. Under no circumstances whatsoever may the bid forms be retyped or redrafted. Photocopies of the original bid documentation may be used, but an original signature must appear on such photocopies. 3. The bidder is advised to check the number of pages and to satisfy himself that none are missing or duplicated. 4. Bids submitted must be complete in all respects. 5. Bids shall be lodged at the address indicated not later than the closing time specified for their receipt, and in accordance with the directives in the bid documents. 6. Each bid shall be addressed in accordance with the directives in the bid documents and shall be lodged in a separate sealed envelope, with the name and address of the bidder, the bid number and closing date indicated on the envelope. The envelope shall not contain documents relating to any bid other than that shown on the envelope. If this provision is not complied with, such bids may be rejected as being invalid. 7. All bids received in sealed envelopes with the relevant bid numbers on the envelopes are kept unopened in safe custody until the closing time of the bids. Where, however, a bid is received open, it shall be sealed. If it is received without a bid number on the envelope, it shall be opened, the bid number ascertained, the envelope sealed and the bid number written on the envelope. 8. A specific box is provided for the receipt of bids, and no bid found in any other box or elsewhere subsequent to the closing date and time of bid will be considered. 9. No bid sent through the post will be considered if it is received after the closing date and time stipulated in the bid documentation, and proof of posting will not be accepted as proof of delivery. 10. No bid submitted by telefax, telegraphic or other electronic means will be considered. 11. Bidding documents must not be included in packages containing samples. Such bids may be rejected as being invalid. 12. Any alteration made by the bidder must be initialled. 13. Use of correcting fluid is prohibited. 14. Bids will be opened in public as soon as practicable after the closing time of bid. 15. Where practical, prices are made public at the time of opening bids. 16. If it is desired to make more than one offer against any individual item, such offers should be given on a photocopy of the page in question. Clear indication thereof must be stated on the schedules attached. Page 7

8 SECTION D DECLARATION OF INTEREST 1. Any legal person, including persons employed by the state¹, or persons having a kinship with persons employed by the state, including a blood relationship, may make an offer or offers in terms of this invitation to bid (includes an advertised competitive bid, a limited bid, a proposal or written price quotation). In view of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons employed by the state, or to persons connected with or related to them, it is required that the bidder or his/her authorised representative declare his/her position in relation to the evaluating/adjudicating authority where- - the bidder is employed by the state; and/or - the legal person on whose behalf the bidding document is signed, has a relationship with persons/a person who are/is involved in the evaluation and or adjudication of the bid(s), or where it is known that such a relationship exists between the person or persons for or on whose behalf the declarant acts and persons who are involved with the evaluation and or adjudication of the bid. 2. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid. 2.1 Full Name of bidder or his or her representative:. 2.2 Identity Number: Position occupied in the Company (director, trustee, shareholder², member):. 2.4 Registration number of company, enterprise, close corporation, partnership agreement or trust: Tax Reference Number: 2.6 VAT Registration Number: The names of all directors/trustees/shareholders/members, their individual identity numbers, tax reference numbers and, if applicable, employee/persal numbers must be indicated in paragraph 3 below. ¹ State means (a) any national or provincial department, national or provincial public entity or constitutional institution within the meaning of the Public Finance Management Act, 1999 (Act No. 1 of 1999); (b) (c) (d) (e) any municipality or municipal entity; provincial legislature; national Assembly or the national Council of provinces; or Parliament. ² Shareholder means a person who owns shares in the company and is actively involved in the management of the enterprise or business and exercises control over the enterprise. 2.7 Are you or any person connected with the bidder YES/NO presently employed by the State? Page 8

9 2.7.1 If so, furnish the following particulars: Name of person/director/trustee/shareholder/member:... Name of state institution at which you or the person connected to the bidder is employed :. Position occupied in the state institution:. Any other particulars: If you are presently employed by the State, did you obtain YES/NO the appropriate authority to undertake remunerative work outside employment in the public sector? If yes, did you attach proof of such authority to the bid YES/NO document? (Note: Failure to submit proof of such authority, where applicable, may result in the disqualification of the bid If no, furnish reasons for non-submission of such proof: Did you or your spouse, or any of the company s directors/ YES/NO trustees/shareholders/members or their spouses conduct business with the state in the previous twelve months? If so, furnish particulars: Do you, or any person connected with the bidder, have YES/NO any relationship (family, friend, other) with a person employed by the state and who may be involved with the evaluation and or adjudication of this bid? If so, furnish particulars Are you, or any person connected with the bidder, YES/NO aware of any relationship (family, friend, other) between any other bidder and any person employed by the state who may be involved with the evaluation and or adjudication of this bid? Page 9

10 If so, furnish particulars Do you or any of the directors/trustees/shareholders/members YES/NO of the company have any interest in any other related companies whether or not they are bidding for this contract? If so, furnish particulars:... 3 Full details of directors/trustees/members/shareholders. Full Name Identity Number Personal Income Tax Reference Number State Employee Number/Persal Number 4 DECLARATION I, THE UNDERSIGNED (NAME) CERTIFY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 2 and 3 ABOVE IS CORRECT. I ACCEPT THAT THE STATE MAY REJECT THE BID OR ACT AGAINST ME SHOULD THIS DECLARATION PROVE TO BE FALSE... Signature. Position.. Date Name of bidder Page 10

11 SECTION F PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS 2011 This preference form must form part of all bids invited. It contains general information and serves as a claim form for preference points for Broad-Based Black Economic Empowerment (B-BBEE) Status Level of Contribution NB: BEFORE COMPLETING THIS FORM, BIDDERS MUST STUDY THE GENERAL CONDITIONS, DEFINITIONS AND DIRECTIVES APPLICABLE IN RESPECT OF B-BBEE, AS PRESCRIBED IN THE PREFERENTIAL PROCUREMENT REGULATIONS, GENERAL CONDITIONS 1.1 The following preference point systems are applicable to all bids: - the 80/20 system for requirements with a Rand value of up to R (all applicable taxes included); and - the 90/10 system for requirements with a Rand value above R (all applicable taxes included). 1.2 The value of this bid is estimated to exceed R (all applicable taxes included) and therefore the 90/10 system shall be applicable. 1.3 Preference points for this bid shall be awarded for: (a) (b) Price; and B-BBEE Status Level of Contribution The maximum points for this bid are allocated as follows: PRICE B-BBEE STATUS LEVEL OF CONTRIBUTION 10 Total points for Price and B-BBEE must not exceed 100 POINTS 1.4 Failure on the part of a bidder to fill in and/or to sign this form and submit a B-BBEE Verification Certificate from a Verification Agency accredited by the South African Accreditation System (SANAS) to Provincial Treasury or a Registered Auditor approved by the Independent Regulatory Board of Auditors (IRBA) or an Accounting Officer as contemplated in the Close Corporation Act (CCA) together with the bid, will be interpreted to mean that preference points for B-BBEE status level of contribution are not claimed The purchaser reserves the right to require of a bidder, either before a bid is adjudicated or at any time subsequently, to substantiate any claim in regard to preferences, in any manner required by the purchaser. Page 11

12 2. DEFINITIONS 2..1 all applicable taxes includes value-added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies; 2.2 B-BBEE means broad-based black economic empowerment as defined in section 1 of the Broad -Based Black Economic Empowerment Act; 2.3 B-BBEE status level of contributor means the B-BBEE status received by a measured entity based on its overall performance using the relevant scorecard contained in the Codes of Good Practice on Black Economic Empowerment, issued in terms of section 9(1) of the Broad-Based Black Economic Empowerment Act; 2.4 bid means a written offer in a prescribed or stipulated form in response to an invitation by an organ of state for the provision of services, works or goods, through price quotations, advertised competitive bidding processes or proposals; 2.5 Broad-Based Black Economic Empowerment Act means the Broad-Based Black Economic Empowerment Act, 2003 (Act No. 53 of 2003); 2.6 comparative price means the price after the factors of a non-firm price and all unconditional discounts that can be utilized have been taken into consideration; 2.7 consortium or joint venture means an association of persons for the purpose of combining their expertise, property, capital, efforts, skill and knowledge in an activity for the execution of a contract; 2.8 contract means the agreement that results from the acceptance of a bid by an organ of state; 2.9 EME means any enterprise with an annual total revenue of R5 million or less Firm price means the price that is only subject to adjustments in accordance with the actual increase or decrease resulting from the change, imposition, or abolition of customs or excise duty and any other duty, levy, or tax, which, in terms of the law or regulation, is binding on the contractor and demonstrably has an influence on the price of any supplies, or the rendering costs of any service, for the execution of the contract; 2.11 functionality means the measurement according to predetermined norms, as set out in the bid documents, of a service or commodity that is designed to be practical and useful, working or operating, taking into account, among other factors, the quality, reliability, viability and durability of a service and the technical capacity and ability of a bidder; 2.12 non-firm prices means all prices other than firm prices; 2.13 person includes a juristic person; 2.14 rand value means the total estimated value of a contract in South African currency, calculated at the time of bid invitations, and includes all applicable taxes and excise duties; 2.15 sub-contract means the primary contractor s assigning, leasing, making out work to, or employing, another person to support such primary contractor in the execution of part of a project in terms of the contract; 2.16 total revenue bears the same meaning assigned to this expression in the Codes of Good Practice on Black Economic Empowerment, issued in terms of section 9(1) of the Broad-Based Black Economic Empowerment Act and promulgated in the Government Gazette on 9 February 2007; 2.17 trust means the arrangement through which the property of one person is made over or bequeathed to a trustee to administer such property for the benefit of another person; and 2.18 trustee means any person, including the founder of a trust, to whom property is bequeathed in order for such property to be administered for the benefit of another person. Page 12

13 3. ADJUDICATION USING A POINT SYSTEM 3.1 The bidder obtaining the highest number of total points will be awarded the contract subject to compliance to all other requirements. 3.2 Preference points shall be calculated after prices have been brought to a comparative basis taking into account all factors of non-firm prices and all unconditional discounts;. 3.3 Points scored will be rounded off to the nearest 2 decimal places. 3.4 In the event that two or more bids have scored equal total points, the successful bid must be the one scoring the highest number of preference points for B-BBEE. 3.5 However, when functionality is part of the evaluation process and two or more bids have scored equal points including equal preference points for B-BBEE, the successful bid must be the one scoring the highest score for functionality. 3.6 Should two or more bids be equal in all respects, the award shall be decided by the drawing of lots. 4. POINTS AWARDED FOR PRICE 4.1 THE 80/20 OR 90/10 PREFERENCE POINT SYSTEMS A maximum of 80 or 90 points is allocated for price on the following basis: 80/20 or 90/10 Where Pt P min Pt P min Ps 80 1 or Ps 90 1 P min P min Ps = Points scored for comparative price of bid under consideration Pt = Comparative price of bid under consideration Pmin = Comparative price of lowest acceptable bid Page 13

14 5. Points awarded for B-BBEE Status Level of Contribution 5.1 In terms of Regulation 5 (2) and 6 (2) of the Preferential Procurement Regulations, preference points must be awarded to a bidder for attaining the B-BBEE status level of contribution in accordance with the table below: B-BBEE Status Level of Contributor Number of points (90/10 system) Number of points (80/20 system) Non-compliant contributor Bidders who qualify as EMEs in terms of the B-BBEE Act must submit a certificate issued by an Accounting Officer as contemplated in the CCA or a Verification Agency accredited by SANAS or a Registered Auditor Provincial Treasury. Registered auditors do not need to meet the prerequisite for IRBA s approval for the purpose of conducting verification and issuing EMEs with B-BBEE Status Level Certificates. 5.3 Bidders other than EMEs must submit their original and valid B-BBEE status level verification certificate or a certified copy thereof, substantiating their B-BBEE rating issued by a Registered Auditor approved by IRBA or a Verification Agency accredited by SANAS to Provincial Treasury. 5.4 A trust, consortium or joint venture, will qualify for points for their B-BBEE status level as a legal entity, provided that the entity submits their B-BBEE status level certificate. 5.5 A trust, consortium or joint venture will qualify for points for their B-BBEE status level as an unincorporated entity, provided that the entity submits their consolidated B-BBEE scorecard as if they were a group structure and that such a consolidated B-BBEE scorecard is prepared for every separate bid. 5.6 Tertiary institutions and public entities will be required to submit their B-BBEE status level certificates in terms of the specialized scorecard contained in the B-BBEE Codes of Good Practice. 5.7 A person will not be awarded points for B-BBEE status level if it is indicated in the bid documents that such a bidder intends subcontracting more than 25% of the value of the contract to any other enterprise that does not qualify for at least the points that such a bidder qualifies for, unless the intended sub- contractor is an EME that has the capability and ability to execute the subcontract. 5.8 A person awarded a contract may not sub-contract more than 25% of the value of the contract to any other enterprise that does not have an equal or higher B-BBEE status level than the person concerned, unless the contract is sub-contracted to an EME that has the capability and ability to execute the sub-contract. Page 14

15 6. BID DECLARATION 6.1 Bidders who claim points in respect of B-BBEE Status Level of Contribution must complete the following: 7. B-BBEE STATUS LEVEL OF CONTRIBUTION CLAIMED IN TERMS OF PARAGRAPHS AND B-BBEE Status Level of Contribution:. = (maximum of 10 or 20 points) (Points claimed in respect of paragraph 7.1 must be in accordance with the table reflected in paragraph 5.1 and must be substantiated by means of a B-BBEE certificate issued by a Verification Agency accredited by SANAS or a Registered Auditor approved by IRBA or an Accounting Officer as contemplated in the CCA). 8 SUB-CONTRACTING 8.1 Will any portion of the contract be sub-contracted? YES/NO (delete which is not applicable) If yes, indicate: (i) what percentage of the contract will be subcontracted?.... % (ii) the name of the sub-contractor?.. (iii) the B-BBEE status level of the sub-contractor?.. (iv) whether the sub-contractor is an EME? YES/NO (delete which is not applicable) 9 DECLARATION WITH REGARD TO COMPANY/FIRM 9.1 Name of company/firm : VAT registration number : Company registration number : TYPE OF COMPANY/FIRM Partnership/Joint Venture/Consortium One person business/sole propriety Close corporation Company (Pty) Limited [TICK APPLICABLE BOX] 9.5 DESCRIBE PRINCIPAL BUSINESS ACTIVITIES COMPANY CLASSIFICATION Manufacturer Supplier Professional service provider Other service providers, e.g. transporter, etc. [TICK APPLICABLE BOX] 9.7 Total number of years the company/firm has been in business? Page 15

16 9.8 I/we, the undersigned, who is/are duly authorised to do so on behalf of the company/firm, certify that the points claimed, based on the B-BBE status level of contribution indicated in paragraph 7 of the foregoing certificate, qualifies the company/firm for the preference(s) shown and I/we acknowledge that: (i) (ii) (iii) (iv) The information furnished is true and correct; The preference points claimed are as indicated in paragraph 1 of this form. In the event of a contract being awarded as a result of points claimed as shown in paragraph 7, the contractor may be required to furnish documentary proof to the satisfaction of the purchaser that the claims are correct; If the B-BBEE status level of contribution has been claimed or obtained on a fraudulent basis or any of the conditions of contract have not been fulfilled, the purchaser may, in addition to any other remedy it may have (a) (b) (c) (d) (e) disqualify the person from the bidding process; recover costs, losses or damages it has incurred or suffered as a result of that person s conduct; cancel the contract and claim any damages which it has suffered as a result of having to make less favourable arrangements due to such cancellation; restrict the bidder or contractor, its shareholders and directors, or only the shareholders and directors who acted on a fraudulent basis, from obtaining business from any organ of state for a period not exceeding 10 years, after the audi alteram partem (hear the other side) rule has been applied; and forward the matter for criminal prosecution SIGNATURE(S) OF BIDDER(S) DATE:.. ADDRESS: WITNESSES: 1. DATE: DATE:... Page 16

17 SECTION G DECLARATION CERTIFICATE FOR LOCAL PRODUCTION AND CONTENT This Standard Bidding Document (SBD) must form part of all bids invited. It contains general information and serves as a declaration form for local content (local production and local content are used interchangeably). Before completing this declaration, bidders must study the General Conditions, Definitions, Directives applicable in respect of Local Content as prescribed in the Preferential Procurement Regulations, 2011 and the South African Bureau of Standards (SABS) approved technical specification number SATS 1286:201x. 1. General Conditions 1.1. Preferential Procurement Regulations, 2011 (Regulation 9. (1) and 9. (3) make provision for the promotion of local production and content Regulation 9.(1) prescribes that in the case of designated sectors, where in the award of bids local production and content is of critical importance, such bids must be advertised with the specific bidding condition that only locally produced goods, services or works or locally manufactured goods, with a stipulated minimum threshold for local production and content will be considered Regulation 9.(3) prescribes that where there is no designated sector, a specific bidding condition may be included, that only locally produced services, works or goods or locally manufactured goods with a stipulated minimum threshold for local production and content, will be considered Where necessary, for bids referred to in paragraphs 1.2 and 1.3 above, a two stage bidding process may be followed, where the first stage involves a minimum threshold for local production and content and the second stage price and B-BBEE A person awarded a contract in relation to a designated sector, may not sub-contract in such a manner that the local production and content of the overall value of the contract is reduced to below the stipulated minimum threshold The local content (LC) as a percentage of the bid price must be calculated in accordance with the SABS approved technical specification number SATS 1286: 201x as follows: LC = 1 x 100 Where x y imported content bid price excluding value added tax (VAT) Prices referred to in the determination of x must be converted to Rand (ZAR) by using the exchange rate published by South African Reserve Bank (SARB) at 12:00 on the date, one week (7 calendar days) prior to the closing date of the bid as indicated in paragraph 4.1 below A bid will be disqualified if: the bidder fails to achieve the stipulated minimum threshold for local production and content indicated in paragraph 3 below; and. this declaration certificate is not submitted as part of the bid documentation. Page 17

18 2. Definitions 2.1. bid includes advertised competitive bids, written price quotations or proposals; 2.2. bid price price offered by the bidder, excluding value added tax (VAT); 2.3. contract means the agreement that results from the acceptance of a bid by an organ of state; 2.4. designated sector means a sector, sub-sector or industry that has been designated by the Department of Trade and Industry in line with national development and industrial policies for local production, where only locally produced services, works or goods or locally manufactured goods meet the stipulated minimum threshold for local production and content; 2.5. duly sign means a Declaration Certificate for Local Content that has been signed by the Chief Financial Officer or other legally responsible person nominated in writing by the Chief Executive, or senior member / person with management responsibility(close corporation, partnership or individual) imported content means that portion of the bid price represented by the cost of components, parts or materials which have been or are still to be imported (whether by the supplier or its subcontractors) and which costs are inclusive of the costs abroad, plus freight and other direct importation costs, such as landing costs, dock duties, import duty, sales duty or other similar tax or duty at the South African port of entry; 2.7. local content means that portion of the bid price which is not included in the imported content, provided that local manufacture does take place; 2.8. stipulated minimum threshold means that portion of local production and content as determined by the Department of Trade and Industry; and 2.9. sub-contract means the primary contractor s assigning, leasing, making out work to, or employing another person to support such primary contractor in the execution of part of a project in terms of the contract. 3. The stipulated minimum threshold(s) for local production and content for this bid is/are as follows: Description of services, works or goods Stipulated minimum threshold % % % 4. Does any portion of the services, works or goods offered have any imported content? YES / NO 4.1 If yes, the rate(s) of exchange to be used in this bid to calculate the local content as prescribed in paragraph 1.6 of the general conditions must be the rate(s) published by SARB for the specific currency at 12:00 on the date, one week (7 calendar days) prior to the closing date of the bid. The relevant rates of exchange information is accessible on Page 18

19 Indicate the rate(s) of exchange against the appropriate currency in the table below: Currency US Dollar Pound Sterling Euro Yen Other Rates of exchange NB: Bidders must submit proof of the SARB rate (s) of exchange used. LOCAL CONTENT DECLARATION BY CHIEF FINANCIAL OFFICER OR OTHER LEGALLY RESPONSIBLE PERSON NOMINATED IN WRITING BY THE CHIEF EXECUTIVE OR SENIOR MEMBER/PERSON WITH MANAGEMENT RESPONSIBILITY (CLOSE CORPORATION, PARTNERSHIP OR INDIVIDUAL) IN RESPECT OF BID No.... ISSUED BY: (Procurement Authority / Name of Institution):... NB The obligation to complete, duly sign and submit this declaration cannot be transferred to an external authorized representative, auditor or any other third party acting on behalf of the bidder. I, the undersigned,... (full names), do hereby declare, in my capacity as.. of...(name of bidder entity), the following: (a) The facts contained herein are within my own personal knowledge. (b) I have satisfied myself that the goods/services/works to be delivered in terms of the above-specified bid comply with the minimum local content requirements as specified in the bid, and as measured in terms of SATS (c) The local content has been calculated using the formula given in clause 3 of SATS 1286, the rates of exchange indicated in paragraph 4.1 above and the following figures: Bid price, excluding VAT (y) Imported content (x) Stipulated minimum threshold for Local content (paragraph 3 above) Local content %, as calculated in terms of SATS 1286 R R If the bid is for more than one product, a schedule of the local content by product shall be attached. (d) I accept that the Procurement Authority / Institution has the right to request that the local content be verified in terms of the requirements of SATS (e) I understand that the awarding of the bid is dependent on the accuracy of the information furnished in this application. I also understand that the submission of incorrect data, or data that are not verifiable as described in SATS 1286, may result in the Procurement Authority / Institution imposing any or all of the remedies as provided for in Regulation 13 of the Preferential Procurement Regulations, 2011 promulgated under the Policy Framework Act (PPPFA), 2000 (Act No. 5 of 2000). Page 19

20 SIGNATURE: WITNESS No. 1 WITNESS No. 2 DATE: DATE: DATE: Page 20

21 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION Bag Laundry ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 21

22 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Bedspread Cot Patient 140 x 185cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 22

23 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Bedspread Patient 180 x 230cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 23

24 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket Baby Small Cot 110 x 85cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 24

25 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket Woollen Navy Blue 150 x 200cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 25

26 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket Woollen White 100 x 150cm Winter sheet ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 26

27 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket Woollen White 150 x 200cm Winter sheet ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 27

28 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket 2/2 Twill Cotton White 95 x 130cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 28

29 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Blanket 2/2 Twill Cotton White 180 x 230cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 29

30 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Cover Mattress Nylon 198cm x 90 cm x 125 ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 30

31 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Pillow Polyester 70cm x 44cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 31

32 SECTION I PRICING SCHEDULE FIRM PRICES (PURCHASES) NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT Name of bidder... Bid number: Closing Time 11:00 Closing Date: OFFER TO BE VALID FOR 180 DAYS FROM THE CLOSING DATE OF BID. ITEM NUMBER: DESCRIPTION: Pillow Slip White 50 x 75cm ESTIMATED QUANTITY REQUIRED: UNITS PRICE PER UNIT INCLUDING DELIVERY IN RSA CURRENCY... ** (ALL APPLICABLE TAXES INCLUDED) AMOUNT IN WORDS... TOTAL BID PRICE PER UNIT ESTIMATED QUANTITIES) INCLUDING DELIVERY IN RSA CURRENCY ** (ALL APPLICABLE TAXES INCLUDED) R.. AMOUNT IN WORDS... - Required by: KwaZulu-Natal Department of Health, Central Provincial Stores - At: 200 Mayors Walk, Pietermaritzburg Does the offer comply with the specification(s)? *YES/NO - If not to specification, indicate deviation(s) - Period required for delivery *Delivery: Firm/not firm - Delivery basis Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination. ** all applicable taxes includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies.... Date Date... (Signature of Bidder) (Signature of Witness) Page 32